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Safety and efficacy of augmented-rectangle technique versus delta-shaped anastomosis for treating gastric cancer in total laparoscopic distal gastrectomy

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Abstract

Purpose

This study aimed to evaluate the safety and efficacy of augmented-rectangle technique (ART) versus delta-shaped anastomosis (DA) for treating gastric cancer in total laparoscopic distal gastrectomy.

Methods

In total, 99 patients with distal gastric cancer who underwent ART (n = 60) or DA (n = 39) were considered. Operative data, postoperative recovery, complications, quality of life, and endoscopic findings of both groups were compared.

Results

The ART group had faster postoperative recovery than the DA group, and was better than DA regarding complications. The mode of reconstruction remained an independent predictor of complications, but not postoperative recovery. Dumping syndrome occurred in 3 (5.0%) and 2 patients (5.1%) of ART and DA groups within 30 days after surgery, and 3 (5.0%) and 2 patients (5.1%) 1 year after surgery. Regarding global health status on the EORTC-QLQ-C30 scale, the ART group had better outcomes than the DA group. Gastritis occurred in 38 (63.3%) and 27 (69.3%) patients of ART and DA groups, respectively. Residual food occurred in 8 (13.3%) and 11 (28.2%) patients of ART and DA groups. Reflux esophagitis occurred in 5 (8.3%) and 4 (10.3%) patients of ART and DA groups. Further, bile reflux occurred in 8 (13.3%) and 4 (10.3%) patients of ART and DA groups.

Conclusions

ART has similar advantages to DA for total laparoscopic reconstruction and is superior to DA regarding the incidence of complications, complication grade, and global health status. Furthermore, ART may have potential advantages in postoperative recovery and anastomotic stenosis.

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Data availability

The raw data is available at reasonable request to the corresponding author.

Abbreviations

DG:

Distal gastrectomy

LAG:

Laparoscopic-assisted gastrectomy

TLG:

Total laparoscopic gastrectomy

DA:

Delta-shaped anastomosis

ART:

Augmented rectangle technique

CD:

Clavien-Dindo

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Funding

This work was supported by the Beijing Municipal Administration of Hospitals Incubating Program (No. PX2020001), the Research Foundation of Beijing Friendship Hospital, Capital Medical University (No. Y2018-3) and the Beijing Municipal Science & Technology Commission (No. D171100006517003).

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Author notes

  1. Haiqiao Zhang and Yasheng Xue contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing, 100050, China

    Haiqiao Zhang, Yasheng Xue, Zhi Zheng, Xiaoye Liu, Chenglin Xin, Yong Huang, Jie Yin & Jun Zhang

Authors
  1. Haiqiao Zhang
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  2. Yasheng Xue
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  3. Zhi Zheng
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  4. Xiaoye Liu
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  6. Yong Huang
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  7. Jie Yin
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  8. Jun Zhang
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Contributions

Conceptualization: Jie Yin and Jun Zhang; Data curation: Haiqiao Zhang and Yasheng Xue; Formal analysis: Haiqiao Zhang and Xiaoye Liu; Funding acquisition: Jie Yin and Jun Zhang; Software: Chenglin Xin and Yong Huang; Methodology: Jie Yin and Zhi Zheng; Validation: Jun Zhang and Zhi Zheng; Supervision: Jie Yin and Jun Zhang; Writing – original draft: Haiqiao Zhang and Yasheng Xue; Writing – review & editing: Jie Yin and Jun Zhang.

Corresponding authors

Correspondence to Jie Yin or Jun Zhang.

Ethics declarations

Ethics statement

This study was approved by the Ethics Committee of Beijing Friendship Hospital, Capital Medical University (approval No.2019-P2-060–02). The study conformed to provisions of the Declaration of Helsinki (as revised in 2013).

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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Zhang, H., Xue, Y., Zheng, Z. et al. Safety and efficacy of augmented-rectangle technique versus delta-shaped anastomosis for treating gastric cancer in total laparoscopic distal gastrectomy. Langenbecks Arch Surg 408, 260 (2023). https://doi.org/10.1007/s00423-023-02999-x

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